Considering Context: The Case of Female Sterilization in Brazil

Sara J. Brown, University of Missouri at Columbia

This study, analyzing data from the Demographic and Health Surveys for Brazil, 1986 & 1996, contributes to the understanding of female sterilization in Brazil by investigating the effects of space and time, controlling for age, marital status, parity, socioeconomic status and education, on whether a Brazilian woman will become sterilized. Life table and logistic regression results suggest that after life course variables, urban/rural, and regional location are significant predictors of sterilization. Life course variables represent the personal indicators leading to sterilization; this is only part of the story, however. During the period 1960-1990, the likelihood of a woman becoming sterilized increased greatly. Also, regional location played a significant role in determining sterilization. These factors combined suggest that both time and space influence women’s contraceptive decisions. This data supports the argument that when and where family planning organizations, making sterilization a greater possibility, are introduced first influences women’s contraceptive choices. The area of Brazil with the highest rate of female sterilization is the Central region. The two largest cities in this region are Brasilia (the nation’s capital) and Belo Horizonte (the sight of one of Brazil’s first family planning organizations). Female sterilization is also more common in the Northeastern region of Brazil than in other areas. The presence of family planning organizations and development programs in the early 1960’s help to explain the increased likelihood of sterilization in these regions. With increased access to sterilization over an extended period of time more women choose permanent tubal ligation. The Southern region of Brazil is known for its European culture and education. Women living in this region (including the cities of Rio Grande, Porto Allegre, Florianopolis, and Curitiba) have a relatively higher standard of living than women living in any other area of Brazil. The ability of access contraception through private medical professionals lessens the demand for public assistance programs which provide contraception. Without the presence of family planning agencies advocating sterilization, women living in the South generally choose the pill over female sterilization. This study examines the economic, demographic, life course, and contextual factors which contribute to women choosing female sterilization in Brazil. Economic and social indicators significantly influence a women’s contraceptive choice. Life course events have the greatest impact on when a woman chooses to end fertility. Contextual factors, such as regional location and decade, influence a woman’s contraceptive choice. Family planning organizations have played an important role in decreasing the total fertility rate in Brazil. The establishment of international family planning organizations in the mid 1960’s corresponds with the increasing rate of female sterilization. Although a causal relationship is not determined in this study, it provides the social context in which to understand Brazil’s fertility transition.